Research Progress of Wastewater-based Epidemiology as an Early Warning System for COVID-19 Pandemic

ABSTRACT

The New Corona Virus Disease(COVID-19) has spread to almost all countries in the world with the cumulative number of confirmed cases reaching 100 million cases. Although the virus spread has been under control in China with occasional cases reported at this stage, there is still a huge risk of the epidemic rebound due to the external unfavorable situation. Before the virus vaccination covers a large group of people, an effective early warning system of COVID-19 outbreak is still the most needed technical means. In view of the presence of virus particles or genetic material(RNA) in the feces/urine of infected cases, Dutch researcher firstly proposed the idea of monitoring SARS-CoV-2 via wastewater-based epidemiology(WBE). So far, the preliminary studies have proved the feasibility of this technology on SARS-CoV-2 surveillance as an early warning. WBE may also characterize the virus transmission dynamics and trends, estimate the prevalence of infected cases, and even locate the infected cases. The present review firstly summarized the development and application of WBE technology in China. Then, a comprehensive analysis was conducted regarding so far what we know about WBE and what WBE can do for us in terms of SARS-CoV-2 surveillance. Finally, a standard protocol for WBE implementation and the areas for further research were presented. Overall, this work is expected to convey timely information and be a reference for the further epidemic control in China.